Seeking the Right Balance between Health Care Cost & Quality

May 24, 2012

Massachusetts – a mecca for medical research, education and innovation – achieved a significant first in 2006 when it mandated insurance for every citizen. Today, 98 percent of state residents have coverage. Next on the health-care agenda: cutting costs without sacrificing quality.

A multidisciplinary group of thinkers dissected the health-care crisis, possible solutions and roadblocks before more than 200 guests gathered at Suffolk University Law School’s Rappaport Center for Law and Public Service to hear the latest on “The Cost of Health Care: Finding the Right Balance.” The forum was co-sponsored with Harvard University's Rappaport Institute for Greater Boston.
.
Public- and private-sector experts discussed the monumental changes proposed in the Legislature’s Health Care Quality Improvement and Cost Reduction Act of 2012. The bill, as written by state Rep. Steven Walsh, House chair of the Joint Committee on Health Care Financing and a panelist at the event, would save Massachusetts $160 million in health-care costs over the next 15 years.

All agreed that the mandate is to cut costs, improve quality, give money back to services that impact health, and ensure that cost aligns with quality.

“Massachusetts can no longer afford to maintain this level of health-care spending,” said medical economist Amitabh Chandra, professor of Public Policy and director of Health Care Policy Research at the Harvard Kennedy School of Government. “The trend threatens the sustainability of every other public service. If we care about people’s health, we have to put resources into education, public health, housing, public safety and local aid.”

Suffolk University Law School Professor Renee Landers brought up the importance of federal support for health care.

“State health care reform is very important, but states cannot do it alone,” said Landers. “If the Supreme Court overturns a part or all of the Affordable Health Care Act, we will find ourselves in a very different place. We will have to hit the reset button to figure out how to go forward.”

Proposed solutions included:

•Reducing inefficiencies
•Developing alternative payment structures
•Disclosing costs
•Streamlining care
•Increasing focus on prevention and wellness
“Investment in prevention works,” said Lauren A. Smith, M.D., M.P.H., medical director and chief medical officer of the Massachusetts Department of Public Health. “We know that seven out of ten deaths can be prevented. We need to talk about that and embrace the conversation. Community-level intervention makes it easier for people to stay healthy and not get sick in the first place."

The issue is fraught with complication and controversy. Health-care costs are growing faster than incomes and the economy. As employers and consumers struggle to pay for high health-insurance premiums, state services -- including education, preventive health care, public safety and local aid -- have suffered, because health care consumes approximately 40 percent of the Massachusetts budget.

Harvard University Professor Edward L. Glaeser, the moderator, noted that the forum’s timing could not have been better, as Gov. Deval Patrick was across town talking to the Greater Boston Chamber of Commerce about health-care reform. Meanwhile, the Senate debated the bill a few blocks away on Beacon Hill.

"I was extremely impressed by the collaboration between Harvard and Suffolk in running this important public policy meeting," said Jerome Lyle Rappaport, the prominent Boston lawyer, real estate developer, and civic leader whose charitable foundation funded the two co-sponsoring organizations. "The event achieved the goals that we have always encouraged. It provided a forum to assemble an impressive cross-section of academics and representatives from the public and private sector who work to apply their research to benefit the city and the state."